Once the period of isolation is over too, those quarantined tend to avoid people who cough or sneeze, stay away from crowded enclosed places, and shun all public spaces in the weeks following the quarantine period. Several participants have long-term behavioral changes after the quarantine period, such as vigilant hand washing and avoidance of crowds for few months.

Regretfully many are stigmatized and find that others were treating them differently: avoiding them, withdrawing social invitations, treating them with fear and suspicion, and making critical comments. Even doctors who were treating patients with COVID 19 were subjected to this recently. Financial implications of the isolation, especially if not compensated for the period of absence, or job loss is another major consequence. This is one reason for denial of illness or contact with ill persons and avoiding isolation.

Social distancing on the other hand keeps one within the family and in one’s home but not in public places. There is contact within the family, unless one lives alone. But they are expected to maintain social distance within the family too, which might be impractical if their residence is too crowded. They too suffer in a similar manner but less in numbers and severity.

Two groups among family members require mention as they suffer the social isolation more than others, the elderly as well as children. Since these groups are more vulnerable to be ill with severe disease if contacted with the virus, social distancing is especially suggested with them. However, the elderly when isolated are more likely to feel being ostracized, abandoned and neglected. If elderly also have illness of old age such as dementia, they become more anxious, angry, stressed, agitated and withdrawn.

Children may seek more attachment and be more demanding on parents in such a situation. Children should be educated with an honest and age appropriate information. They should be helped to express their disturbing feelings such as fear and sadness, in their own unique way. Creative activity such as playing or drawing assists in such expression of disturbed feelings.

The stressors which give rise to the distress include:

Duration of quarantine – especially if it keeps extending

Fears of infection – can come from anywhere

Frustration and boredom – as it is imposed rather than sought

Inadequate supplies of items of daily living – leading to hoarding

Inadequate and improper information – more myths than facts

Coping with social distancing requires a multi pronged approach with inputs both from authorities as

well as the individual. They include:

1. Restricting the length of quarantine - to what is scientifically reasonable given the known duration of incubation periods, and not adopting an overly precautionary approach, which would minimize the effect on people.

2. Giving people as much information as possible – in this information age, more myths and falsehoods reach people than scientific facts. Ensuring that all have a good understanding of the disease, and the reasons for social distancing, should be a priority. People too should access trusted sites such as those of WHO, from the websites of government or reputed scientific / health institutions. People need to avoid seeking information sent out by social media sites as they tend to exaggerate or underplay the issue. Knowing that our country and the world has gone through many such pandemics and have come out of it, instills a sense of hope.

3. Provision of adequate supplies – to ensure that people can maintain a basic standard of life and ensure that there is no shortage of resources

4. Reduction of frustration, boredom and improvement of communication - is something which individuals should strive to achieve. Provision of methods of communication with robust wifi networks and internet access to allow them to communicate directly with loved ones could reduce feelings of isolation and stress. Continuing a routine, which to a great extent coincides with one earlier followed, with fixed times for awakening, sleeping, getting ready, meals and exercise helps providing a sense of time, which is lost in such times. Luxuries such as afternoon naps which one could not do otherwise could fill in the gap.

One should use this opportunity to start and finish what one could not do when busy earlier, such as reading, writing, taking up an old hobby, finishing assignments, gardening, cooking, cleaning the house, exercise and yoga, including meditation, spending time with family, networking with friends and relatives, and skill building. This is a god given opportunity to slow down, relax, and rejuvenate getting ready to action once the crisis ends.

5. Altruism – This social distancing is voluntary to a large extent, rather than mandatory. Only unnecessary movement has been restricted. Feeling that others will benefit from the attempt to maintain social distance makes stressful situations easier to bear, especially in home-based quarantine. Reinforcing that quarantine is helping to keep others safe, including those vulnerable, such as those who are very young, old, or with pre-existing serious medical conditions, and that authorities are genuinely grateful to them, can only help to reduce the mental health effect and adherence.

Depriving people of their liberty for the wider public good is often contentious and needs to be handled carefully. If quarantine is essential, officials should take every measure to ensure that this experience is as tolerable as possible for people. This can be achieved by: telling people what is happening and why, explaining how long it will continue, providing meaningful activities for them to do while in quarantine, providing clear communication, ensuring basic supplies (such as food, water, and medical supplies) are available, and reinforcing the sense of altruism that one should rightly be feeling. It’s up to the citizenry to make good of an unavoidable situation and spend this three week free time purposefully and with enjoyment.